Authors

1. Maki, Kaisa LicA (Psych)
2. Nybo, Taina PhD
3. Hietanen, Marja PhD
4. Huovinen, Antti MD
5. Marinkovic, Ivan MD, PhD
6. Isokuortti, Harri MD, PhD
7. Melkas, Susanna MD, PhD

Abstract

Objective: To examine perceived injustice and its associations with self-reported symptoms and return to work at 3 months after injury in a prospectively recruited sample of patients with mild traumatic brain injury (mTBI).

Design: Observational study.

Setting: TBI outpatient unit.

Participants: Adult patients aged 18 to 68 years with mTBI (n = 100) or orthopedic injury ([OI]; n = 34).

Main Measures: The Injustice Experience Questionnaire (IEQ) and its associations with the Rivermead Post Concussion Questionnaire (RPQ), Beck Depression Inventory-Second Edition (BDI-II), PTSD Checklist-Civilian Version (PCL-C), and Pain Visual Analog Scale (PVAS). Information on injury-related characteristics, compensation seeking and litigation, and return-to-work status was also collected.

Results: Median IEQ total score was 3 (range, 0-23) in the mTBI group and 2.5 (range, 0-25) in the OI group. In the mTBI group, IEQ was significantly correlated with RPQ (r_s = 0.638, P < .01), BDI-II (r_s = 0.612, P < .01), PCL-C (r_s = 0.679, P < .01), and PVAS (r_s = 0.232, P < .05). The association between IEQ and PCL-C (r_s =0.797, P < .01) and BDI-II (r_s = 0.395, P < .05) was also found in the OI group. In both groups, patients who were still on sick leave at 3 months after injury tended to report higher perceived injustice (IEQ total score) than patients who had returned to work or studies. However, this difference did not reach statistical significance.

Conclusions: Perceived injustice is associated with self-reported symptoms in patients with mTBI. Our results suggest that perceived injustice could be a relevant construct to consider in clinical management of patients with mTBI. Also, perceived injustice could be a potential target for psychological interventions promoting recovery after mTBI.